Global economic crisis sets stage for HIV spike

Poor countries in South-East Asia could experience a spike in HIV infections and AIDS-related deaths due to the effects of the global economic crisis (GEC), research from the University of New South Wales (UNSW) has found.

With most HIV programs in developing countries externally funded, decreases in aid for critical antiretroviral therapy, testing and education programs pose the greatest risks to HIV prevention programs, according to the National Centre in HIV Epidemiology and Clinical Research (NCHECR).

Papua New Guinea, in the midst of an increasing HIV epidemic, could be hardest hit, with infection rates climbing by as much as 35 percent over three years, and AIDS-related deaths spiking by 15 percent.

A paper reporting on the study appears this month in the journal Current HIV Research.

A large team of researchers led by UNSW's Associate Professor David Wilson identified major HIV-related risk factors that may change due to the GEC in two test countries – Cambodia and PNG – and then used mathematical transmission models to forecast HIV prevalence, diagnoses and incidence over a three-year period.

Cambodia, which currently reports 1,500 new cases of HIV infection each year, could see increases of up to 15 percent due to the economic downturn, the modelling showed. In PNG, where 40,000 people are infected annually, the increase could be as much as 35 percent.

"The study highlights very plausible conditions under which the economic downturn can noticeably influence epidemic trends," says Associate Professor Wilson. "This research reinforces the need to maintain international donor funding for HIV programs even in the midst of an economic downturn."

"We chose two very diverse epidemics. Cambodia, where HIV incidence is in decline, and PNG, where the epidemic is in expansion phase," Associate Professor Wilson said. "In both locations we can see a change in the course of the epidemic due to changes in funding."

The authors said any funding cuts could result in disruption of HIV prevention campaigns, reduced supplies of antiretroviral drugs, and a smaller range of available drugs, particularly second and third-line medications.

"We are already seeing devastation across the region due to the epidemic. In PNG, there are very high HIV prevalence rates in every single province – if resources and programs are reduced the situation could become even worse and we will see many more deaths," Associate Professor Wilson said.

This work was carried out with support from Australian Agency for International Development (AusAID), of the Department of Foreign Affairs and Trade. NCHECR is funded by the Department of Health and Ageing and is affiliated with the Faculty of Medicine, UNSW.

Source: University of New South Wales

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